Concussion Update 2017

In October 2016, world leaders in the field of sport-related concussion (SRC), of which a large proportion are Canadian, met in Berlin to develop the latest statement on our current knowledge of the science of SRC. As a quick review, an SRC is a traumatic brain injury induced by biomechanical force transmitted to head causing functional disturbance. It does not require a direct blow to the head. Some of the new developments and highlights from the statement include:

– A new Sports Concussion Assessment Tool Version 5 (SCAT) was developed

Management

– A brief period (24–48 hours) of cognitive and physical rest is appropriate for most patients

– Subsymptom threshold activities and submaximal exercise are encouraged (as long as symptoms are not exacerbated)

– Cervical spine rehab is recommended for neck pain/headaches

– Vestibular rehab is recommended for dizziness

– Return-to-play and return-to-school/work protocols can advance in parallel

– Children and adolescents should not return to sport until they have successfully returned to school

– Physiological dysfunction may be delayed relative to clinical recovery, suggesting that using a ‘buffer zone’ of a graduated return to activity/return to play progression before full return to contact risk may be appropriate